Carbon dioxide pneumothorax occurring during laparoscopic cholecystectomy

Abstract

A previously fit patient underwent laparoscopic cholecystectomy. During the procedure arterial oxygen saturation fell and clinical examination revealed signs of a right pneumothorax confirmed by chest X ray. Aspiration of the pleural cavity and analysis of the gas removed showed it to be composed entirely of carbon dioxide. Possible mechanisms of entry of carbon dioxide into the pleural space are discussed.